Tag: physical therapy

Things have been busy in life lately, mostly thanks to school, so I’m a little sidetracked. Never fear, rehab is going well, and I called my surgeon’s office after the 10 week mark to let them know. Sometimes there is joint stiffness when it’s cold (welcome to old age), and for a few days after introducing new activities (like weighted calf presses) it’ll be sore. But nearly three months out and halfway to running, I can confidently declare that this has been a huge success and feels great.

It’s been so long since my last post we entered a whole new season during October.

I learned that I am cleared to elliptical, and probably could’ve been doing it already, but what’s the rush? I figured I would need like 12 weeks, but they claim it’s as low-impact as biking. I actually did 8 minutes of it today at PT with the BFR cuffs, and if I can make it through that, I can definitely add it into my routine. I did not make it through pushing a sled. I almost threw up and had to take an emergency apple juice home with me.

My PT told me today he doesn’t think much further work is needed currently, but I’ve got three more sessions scheduled so I’ll keep going to those. I know, my balancing skills are just too impressive. What can I say. But actually this is the strongest I’ve ever felt as far as core stability is concerned. Three more months to really max that out! On nice days when I pass my favorite alleys in town I get an overwhelming urge to take off and run to my heart’s desire. Soon. Soon.

So my workout routines have basically been the same for two or three weeks since I last wrote, but here’s a general idea:

MON: 30-60 min bike, steady or w/ intervals, core, easy lift

TUE: 45 min aqua jog

WEDS: 30 min bike, option to add 30 min aqua jog, core

THUR: 45 min aqua jog, PT

FRI: 45-60 min bike, steady or w/ intervals, core, easy lift

SAT: 30-50 lap swim

SUN: off

I’ve been slowly phasing out the daily aqua jogging sessions in favor of doing prolonged pool days on Tuesdays and Thursdays when my buddies are there. Some days my anxiety is so bad that getting in a decent water run just isn’t possible. So I know I can make it 45 minutes when my friends are there, but otherwise I’d rather spend more time on the bike. I actually biked around town for the first time in months the other day, just because it was nice out and my pool day hadn’t gone well. You gotta do what you gotta do, ya know?

I’d like to get back to yoga. I think my stability and ROM can handle it at this point, so now I could really use it for the added benefits of flexibility and strength. I notice I tend to be less injured when I go to yoga regularly, but it’s hard to be consistent. I either wanna go four times a week or not at all. I did procure a Pilates pass from my absolute favorite instructor this week, so I’ll be adding private reformer classes for the next few weeks after I phase out PT, and I am PUMPED! This is gonna be a hell of a comeback. A baby comeback, but it’ll be strong as fuck.

That’s about all for now, but I will leave a decent dump of photos from a display case I installed recently for a design class. I ambitiously chose the topic “Women in Sports History,” and this is very near and dear to my heart so I really bit off more than I could chew, but I think it was worth it. Initially, the idea came from wanting to celebrate the iconic moments in running that have been happening lately, from Shalane and Desi winning major marathon titles to Courtney and Emma dominating the steeplechase. But then I kept thinking of more and more special moments, in other sports, and I realized this project was becoming bigger than I anticipated.

Part way through planning, I knew that it was important to me to recognize as many sports as possible, performed by as many women as possible from around the world. So I made sure to give attention to the women of color who dominate sport, as well as to women from non-Western areas who are making huge impacts in their native countries, often because it goes against their customs to participate. Obviously, there’s so much to unpack just at that level. But I’m really proud of how the installation came together, even though I panicked for three days straight, forgot to sleep and eat, and missed a workout or two.

Please enjoy the photos and let me know if you want more information or have additional insights to share.

Not much to discuss anymore, which is probably a good thing. Last week I was able to liberate myself from the boot, likely forever, and I started taking the stairs again (!), so things are feeling much better. At PT I learned that the swelling looked minimal, and that having my incisions massaged is a special kind of torture. By the way, last week marked two months since surgery!

Two months later and it’s 35-degrees out. Definitely not August anymore.

I made some other advancements at PT, too, like re-introducing standing leg exercises. I did some leg presses on the reclining slide board, as well as theraband walks, single leg step downs, and balances on one leg. These are all welcome additions to my now-very-stale mat routine. During single leg balances, I impressed my PT (as well as myself) by making a spectacular save for a ball that rebounded poorly, and I chalked it all up to many years of stability training in the bank. Let’s hope my aerobic memory proves just as good as my muscle memory.

I also spent some time with the blood flow resistance cuffs, so I can explain that a little more now. It’s exactly what it sounds like — a blood pressure cuff from hell. They slide all the way up the thigh, and then my PT pumps up the cuffs while monitoring a pulse in my leg, and sets the pressure near 70% restriction. It’s not exactly a comfortable experience. I imagine it’s what being killed by a boa constrictor feels like. And it makes it super hard to use your legs.

The science is that by cutting off venous return (and some arterial flow), essentially depriving the tissues of oxygen, the cuffs simulate the work of an anaerobic or a lactic session without literally doing the work. So when the cuffs are on, we do leg presses or hip bridges basically to exhaustion, which doesn’t take as long as you’d think. It’s fucking hard. Plus, you stimulate production of anaerobic enzymes and it supposedly offers a great aerobic benefit by just walking around.

On Friday I suffered for 8 minutes on the treadmill at 1.7 MPH and felt like I’d run a tempo. Not like I was physically stressed or breathing hard, but my legs were like lead after that. It’s definitely weird. You can feel every muscle contracting. PT said he had someone get light headed with them recently, and yeah I could see that, especially if you’re not well-trained or accustomed to the feeling of exertion. The first time they made me anxious, but I’m more relaxed about them now.

Last week I worked on extending time spent in the pool and on the bike, and finally added a couple turns of resistance to the spin bike by the end of the week. I have started making pool friends too! A pair of students comes several times a week accompanying a very old man named Pablo while he swims laps, so we occasionally spend a lap or two chatting as we tread past each other.

Here’s the workouts from last week:

MON: 20 min cycle w/ zero resistance, 20 min aqua jog, core + lift

TUES: PT, 30 min aqua jog

WEDS: 20 min bike w/ zero resistance, 20 min aqua jog, core

THUR: 30 min aqua jog

FRI: 30 min cycle w/ some added resistance, core, PT w/ BFR cuffs

SAT: Swam 40 laps at the Rec center, about 20 mins of work (it’s a short pool, don’t be too impressed)

SUN: Off

A new week is already kicking along, so I’ll have another update in a couple days.

On our last (maybe so) warm and sunny day, I harvested all my remaining tomatoes and pulled up the stalks. It made me sad, and then it snowed two days later.

Now that I’ve rejoined the land of the living for over a whole week, it’s hard to remember ever stumbling around on crutches. I’ve been wearing the boot a lot. I don’t wear it 24/7, but for lengthy bouts on campus or running errands, it has been helpful. Throughout the week there’s been some swelling along with pain near the talus, which I’m sure isn’t unusual after surgery. So staying strapped into the boot during the week alleviates that, and it was starting to feel better this weekend. It’s helpful to ice and elevate (I should follow my own advice and do those things more often), and to get out of the boot for periodically to avoid stiffness.

I did a fair amount of gardening this weekend because I think it’s about to start frosting for good, and my weeds were out of control. So I cleaned up beds and dug up the mint that was starting to run across the yard. My tenant’s boyfriend called me a 70-year-old. Okay, well, I’d rather tend to housekeeping priorities that bring joy instead of hiding in bed with a hangover on a Sunday morning, if that’s what you’re implying. Because yeah… I’m definitely too old for that.

Anyway, this first week has been productive without over-doing anything. There is literally no rush, so I’m like hey even if I need to use the boot for the next two weeks, that’s okay. I changed my expectations more than once, but was also surprised a couple times by how easily things were going. For instance, I’m realizing I won’t be ready to attempt yoga for a few more weeks still, but aqua jogging 20 minutes was way more manageable than anticipated, aside from super tired hamstrings.

Well… if you think any program like that can get you ripped, think again. My pelvic floor may be stronger than ever but otherwise it offered few benefits except a routine. One leg is shriveled and saggy, the other is only slightly stronger. I have zero aerobic capacity to speak of, and I don’t have a six-pack. But, of utmost concern to everyone going through a similar situation, no, I didn’t really gain any weight. My secret is… I ate normally, didn’t drink for about a month, and was in fairly good shape to begin with.

It’s been almost 72 hours since I kissed my crutches good-bye and limped out the door of the Laramie orthopedic center. I have four and a half months until I’ll be running again, so my goal is to provide the inside scoop on how to get from here to there over that time. I’m pretty immersed with school these days, but I should be able to add updates once a week.

And now to answer that burning question: what is it like to walk again?

I almost barfed on my way out from the doctor’s the other day. All the blood that was pooled in my foot went squirting out in a sharp, unpleasant way, like walking on a limb that’s fallen asleep, plus my leg about collapsed. (It really makes me revisit that unsolved mystery from a month ago; I don’t know if adrenaline is powerful enough to overcome the sensation of walking on an unused leg.) Later that day I walked to the end of my street and back, and it took a whopping ten minutes.

My surgeon’s office told me to wear an air cast boot until I feel comfortable walking regularly in a shoe. I had already come to that conclusion on my own and was glad I’d kept the boot stashed under my bed for the last few months. I wear it when I run errands or have to spend prolonged time on my feet. I just get around a little faster with it. But most of the time I’ve been walking barefoot at home, trying to regain full function.

It actually comes back faster than you’d think. By the end of the third day, walking felt almost normal again. Going up and down stairs is the most difficult. And I can’t walk super fast, but it’s much better than day one when I clocked 40 minutes per mile pace on my neighborhood walk and had to take an ibuprofen.

I don’t really have any photos to add, but look how much my hollyhocks grew while I was sitting around on my ass repairing a joint!

My left calf has been so sore in the mornings it reminds me of college when we could barely make it out of our lofted dorm beds after the first spike day of the track season. I spend a couple minutes in the evenings rolling it on a hard plastic ball to keep the fibers loose. And the first day both my heels were excruciatingly painful by bedtime. Rolling helps with that, too.

I’ll be seeing my PT twice a week for the next four weeks to do “blood flow restriction” training. More on that when I’ve actually witnessed it in person. This week I went in the day after I started walking, and we literally just practiced walking. Which was exhausting and made me feel like a newborn animal. I was still limping heavily at that point, and my PT had me break down the stride cycle by focusing on toe-off and then heel-strike. My muscles were so tired at the end I could barely walk all over again.

This weekend I’ve been visiting the rec center to walk around in the pool. Next week I’ll try aqua jogging on campus, but I’m honestly not quite there yet. For now, I walk back and forth a couple laps, sideways and zig zag, and do leg swings and hip circles. Then I breaststroke a couple lengths (like 10 max — remember when I could do 60?) very slowly. That’s about it and I’m ready for a nap.

I’m still doing my core routines, but now I can add a couple things, like a proper pelvic tilt, bridge, and standing on one leg. I’m not ready for anything resembling yoga, but I got the green light to cycle on zero resistance. No word yet on the elliptical, but realistically I don’t expect to add it until about 10 or 12 weeks post-op.

Holy shit. One week left. It’s a bit hard to believe it’s “already” comin’ in hot, but it still can’t get here quickly enough. A guy on campus blew past me on his bike today and told me to watch where I was going. I almost cried. (As if he would’ve won that case had he actually hit me — not a chance, bro.) So yeah. I wouldn’t mind being through with the whole ordeal. Here are all the things I’m gonna do on repeat when I unleash myself to the world again:

PULL WEEDS!

Swim til I drown

Cook dinner for myself for a week straight

Brew kombucha

Go on a walk

Do ANY exercise that isn’t abs

Shower standing up

Clean my house of ALL evidence of humans and animals alike

Go to the bar. Yeah.

Relearn how to drive my car

Stand exclusively on my left leg for six weeks

It took about 2 weeks for the scabs to fall off after my stitches came out. Pretty minimal scarring. I’ve had shaving accidents worse than that.

I’m not really sure what to expect at my review next week. I assume I’ll be going in with crutches and leaving without them. I’m seeing the Laramie equivalent of the Fort Collins surgeon who actually performed my surgery. I don’t have the resources or time to travel to Fort Collins during a school week for appointments, so I had all my records released and transferred here.

And then it will be back to PT the next day to commence with the real work of restrengthening and retraining.

In the end, no, I did not attempt to swim and will not until I am walking. Most of the feedback I received from friends and family was to listen to the instructions I was given. Which seemed reasonable. As time passed, I also felt less angsty about the lack of exercise and a month hasn’t felt as long as it seemed initially. I have such a long road ahead before I can run anyway that there is little point in rushing anything, and I think the total rest will pay off.

That being said, I’ve very diligently done core and glute activation exercises every day for the past five weeks. Among other causes, I think lack of functional core strength was a major player in this injury, and I had really been neglecting it last summer when everything presented itself. If only runners could actually be counted on to take care of the small things before disaster strikes. We’d put surgeons and therapists out of business.

Credit to bodybybodde.com (Google search) for this crude representation of a prone glute raise

As a point of reference, when I first began physical therapy a year ago, I couldn’t perform this somewhat basic glute exercise ^^ that I have now mastered. And it only took about four weeks! ON A LEG I’M NOT EVEN USING! Runners!! Do your damn core work. It’s cheaper than surgery.

It’s already been two weeks since surgery. Where does the time go? Yesterday I had my post-op review and got the stitches taken out. Here are the questions I took with me, and the answers I received.

How much longer am I restricted to non-weight bearing?

I have been sentenced to the full 6 weeks. Which means I have one more month to endure crutching, hopping, crawling, and pit chafing. I will probably rent a scooter or a peg leg before classes start next week. How I plan on actually getting to campus is still TBD.

Why do I require 6 weeks instead of 2, or 4?

The way it was described to me was to think of a jelly donut. The fibrocartilage needs time to lay down and become strong, or the first steps I take will squish all the jelly out of the donut. Ya feel? It’s disappointing, especially because there isn’t any pain and it seems perfectly possible to walk. But for the sake of healing properly, I’ll take the advice.

When can I start running again?

In 6 months.

Hoooooo, that’s not what I was expecting to hear. I was hoping like 12 weeks. By the time I can run again, a full year will have passed since I last considered myself “healthy” enough to run. A full year since I knew I had to make a change and get help.

My immediate thoughts: at least I won’t be tempted to run over the winter on slick or frozen surfaces or over snowy terrain, and I won’t risk damaging a post-op ankle in an accident. It’ll give me time to really make sure I am healed and strong, and I can spend that time learning to love any form of cross-training I can get my hands on, like it or not.

Can I use the pool?

So… I was told not for four more weeks. But the reasoning was only that getting into and out of the pool may pose difficulties, and “how are you supposed to crutch across a wet pool deck?” Touché. But I’m already eyeing those disability chairs at the rec center, ya know, that dunk you into the pool and lift you out again when you’re done. Methinks I can take advantage of that opportunity, yes? I have to wait for my incisions to be 100% healed, but I’ll probably go for it earlier than four weeks unless I am strongly convinced not to. I am stubborn. Should I swim or no?

What kinds of PT and exercise can I do right now?

Pretty much what I’ve been doing. Core, upper body weight lifting. Nothing that requires applying weight to the operative area. I visited my PT this morning, and he gave me a set of band exercises to try. Gotta keep my intrinsic foot and calf muscles awake. There’s not much else I can tackle for now.

Anything else?

Continue to keep the foot elevated if I am sitting for long periods of time, and ice if swelling occurs. I can switch from bathing with one leg sticking out to sitting on the floor of the shower in three days.

Okay. I can do it. I’ve been on crutches longer than this before. And then what’s another six months. This will finally give me the downtime I’ve always wanted to try some spin classes. I say that with only mild sarcasm. Who wants to run outside in December anyway?

This has been my most difficult post to write, for some reason. I blame the entirely depressing circumstances that surround surgery recovery. My dad went home a week after my procedure, and the last five days without him have been really sad. The first morning I woke up, several hours after he had gone, I cried and cried, feeling totally helpless, useless, pathetic, and lonely.

There isn’t much to do while waiting for a joint to repair itself. There isn’t much I can do. For a week my dad stock-piled my freezer with home cooked meals, watered my gardens, cleaned my house, did my laundry, and moved my laptop from the table to the couch and back again every hour. We ran short errands together so that I could get outside for some fresh air. Now my house is quiet and lonely, just me and the cat — who is decent company but has so far proved to be quite useless at putting dinner on the table and bringing in the mail. I didn’t even unlock my front door for the entire day once. If it sounds sad, it’s definitely worse.

Anyway, four days after surgery I visited my PT to have the bandages removed. He was pleased to see that the swelling around my ankle was minimal. Just some bruising and orange iodine toes. We worked on some range of motion exercises, and then agreed to revisit once I’ve had my stitches removed. Working on PT and some core exercises is about the only thing I actually have on the schedule every day. So, once I get tired of spending the whole day on the couch reading, scrolling, and snacking on reheated food, I crawl into the garage to do my routine.

I start with ankle circles and passive stretching on a wobble board to regain my ROM. The first couple days were really abysmal — it’s amazing how much you lose after only four days. But slowly things improved, and I no longer felt like I was pulling a muscle when I stretched. I also self-massage by rolling my calf on a field hockey ball to loosen things up. At this point, I’d say ROM is probably almost back to normal. There hasn’t been any pain inside the joint, just some tugging at the stitches if I overdo it.

Staying in shape

As far as core, anything where I can stay on my back or off my foot is fair game. I’m still expanding the foot-free possibilities, but a short list of doable exercises includes:

Bicycle, dead bug, scissors, row boats, Russian twist

Firehydrant, donkey kicks, bird dog

Clamshells, leg lifts/hip lifts, hip circles

Hamstring curls, superman/locust/swimmers

Anything that can be done lying on my stomach while clenching my butt cheeks that feels like it requires effort

It might be ugly, but it’s mine. Stocking a home gym has been a total game-changer, and not just after surgery.

I also have a set of small weights that I can use for some arm exercises. It’s not as fun to me as heavy lifting, but I can save that for the gym… whenever I get back in one. At the very least, doing 20 reps of arm lifts in as many directions as I can think of burns off some fidgety energy. I have nothing else to do, I might as well get ahead on my strength.

🎶They tried to make me go to rehab and I was like yea of course I just had surgery🎶

^thanks to Internet compatriots I now have Amy Winehouse stuck in my head forever. What would we do if we couldn’t mistake famous runners for IRL friends? At least he also looks sad.

I’m ready to be done wallowing in self-pity and get back to life. Somehow the school year crept up on me and classes start literally next week. It’s been over a year since I last took a class on this campus, and I’m feeling that rushing anxiety that comes on when something is coming so fast, so inevitably, and you’re completely overwhelmed by your to-do list. There are dishes in my sink I can’t do, weeds in my yard I can’t pull. I keep stressing about getting back to work, and then I have to just stop myself. There’s nothing I can do to rush the recovery process. Work will be there when I am able to go back. The weeds… will definitely still be there. The things will get done that need to get done, it’s just hard to imagine that while I’m currently staring at the ceiling for a living.